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TARA MOON M.D.
NPI 1336403211
Pediatrics in Statesville, NC

Active since June 26, 2012PECOS Enrolled
1410 FERN CREEK DR, STATESVILLE, NC 28625(704) 978-2379(704) 978-2380 Get Directions Write a Review

NPPES record last updated: September 10, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 10, 2020, Dec 23, 2015 (2 updates tracked since 2015).

About Tara Moon M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA MOON M.D. (NPI 1336403211) is an individual pediatrics provider in Statesville, North Carolina, licensed in North Carolina (2015-01302) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336403211
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTARA MOONCredential: M.D.
Location Address1410 FERN CREEK DRStatesville, NC 28625-9376
Mailing Address1410 Fern Creek DrStatesville, NC 28625-9376 · (704) 978-2379 · Fax (704) 978-2380
Phone(704) 978-2379
Fax(704) 978-2380
Sole ProprietorNo
Enumeration DateJune 26, 2012
Last NPPES UpdateSeptember 10, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2020
✔ NPI 1336403211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 2015-01302
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1410 FERN CREEK DR, Statesville, NC 28625
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tara Moon M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Tara Moon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Scotland Memorial Hospital, Inc.
104 mi
Surgery
1007 CHERAW ST
Bennettsville, SC 29512
  • Reassigned Medicare billing, North Carolina enrollment
  • 476 clinicians in this Medicare group
NPI 1598143620 (843) 535-0939
Granville Health System
122 mi
Rural Health
1614 NC HIGHWAY 56
Creedmoor, NC 27522
  • Reassigned Medicare billing, North Carolina enrollment
  • 91 clinicians in this Medicare group
NPI 1265430854 (919) 575-6103

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28625 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 34% · 350 patients
Patients physicalActivity: 33% · 350 patients
72%350 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOVANT HEALTH MEDICAL GROUP, LLC
Internal Medicine
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250
MR. ROBERT DEAN SWEDLUND PA
Physician Assistant
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250
MEGAN STANLEY LEWIS FNP
Nurse Practitioner
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250
IREDELL PHYSICIAN NETWORK LLC
Family Medicine
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250
SAMUEL EKRO INKUMSAH MD
Family Medicine
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250
MR. DAVID LEE ZAHM PA-C
Physician Assistant
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 873-7012
HANNAH BROOKE BROWN FNP
Nurse Practitioner (Family)
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2250
STATESVILLE HMA MEDICAL GROUP, LLC
Obstetrics & Gynecology
1410 FERN CREEK DR
STATESVILLE, NC 28625
Iredell County (704) 978-2820

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Moon's NPI number?

The NPI number for Tara Moon is 1336403211. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Where is Tara Moon located?

Tara Moon practices at 1410 Fern Creek Dr, Statesville, NC 28625. The listed phone number is (704) 978-2379.

What is Tara Moon's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Tara Moon enrolled in Medicare?

Yes. Tara Moon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tara Moon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tara Moon reassigns Medicare benefits to 2 organizations: Scotland Memorial Hospital, Inc. (Bennettsville, SC) and Granville Health System (Creedmoor, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tara Moon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tara Moon accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC and UnitedHealthcare list Tara Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tara Moon was last updated on September 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.